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O268 Hepatitis B virus and Hepatitis C virus in pregnant Sudanese women
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S93–S396
instrumental delivery & birth trauma were excluded. 100 patients were received either oxytocin or methergine immediately after delivery, & 100 patients were received misoprostol 400 mg either buccal (50 patients) or rectal (50 patients) immediately after delivery, both groups were around the same parity, around 70% of the patient were ≤p4 & 30% were >p4. In group (1) oxytocin group 21 patient develop P.P.H & 4 patient need blood transfusion. In group (2) misoprostol group, 6 patients develop P.P.H after misoprostol And given piton ± methergine in this category the birth weight of the baby >4 kg One of them receive 1 unit blood transfusion & one of them post partum evacuation done because of retained placental tissue. All these patients were >85 kg weight & there age between 25–34 years. In misoprostol group (group 2) 2 patient developed diarrhea & 3patient developed vomiting as drug side effect. There’s no significant difference in the effect &side effect of misoprostol which given either rectally or buccal, but buccal is more accepted by the patient. There’s no significant difference in days of hospital stay between the two groups. Results of our study show that: There’s significant Reduction of p.p.H & the need of blood transfusion when misoprostol used instead of oxytocin or methergine as an active management of 3rd stage of labour. In conclusion, P.p.H witch occur with misoprostol could be related to the patient weight & to the baby birth weight. O266 From Kuala Lumpur (2006) to Cape Town (2009), novasure impedance controlled endometrial ablation – Three-year follow up
S169
O267 Ultrasonographic evaluation of lower uterine segment thickness in pregnant women with previous cesarean section D. Elmoghazy. Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Egypt Objective: To evaluate the lower uterine segment thickness in pregnant women with previous cesarean section by ultrasonography in comparison to those with previous normal vaginal delivery, and to determine a critical thickness above which safe vaginal delivery is predictable. Methods: A prospective observational study of 100 antenatal women with previous cesarean delivery and 50 controls was carried out. Transabdominal and transvaginal ultrasonography were used in both groups to evaluate lower uterine segment thickness. The obstetric outcome in patients with successful vaginal birth and intraoperative findings in women undergoing cesarean delivery were correlated with lower segment thickness. Results: The overall vaginal birth after cesarean section (VBAC) was 68%, the incidence of dehiscence was 28%, and there were no uterine ruptures. There was an 86% correlation between transabdominal ultrasonography with magnification and transvaginal ultrasonography. The critical cutoff value for safe lower segment thickness, derived from the receiver operator characteristic curve, was 2.5 mm. Conclusion: Ultrasonographic evaluation permits better assessment of the risk of scar complication intrapartum, and could allow for safer management of delivery.
A. Elmardi1 , M. Hamza, S. Furara, F. Khan, I. Gallos, A. Yagoub. 1 Obstetrics and Gynaecology department, Stafford General Hospital, Stafford, UK
O268 Hepatitis B virus and Hepatitis C virus in pregnant Sudanese women
Objectives: – To assess the safety, efficacy and patient satisfaction after the procedure in women with menorrhagia secondary to dysfunctional uterine bleeding – To compare our current results (bigger sample size and longer duration post treatment) to initial results presented at Kuala Lumpur in 2006. Materials and Methods: Note: The numbers into brackets represent our initial figures presented at Kuala Lumpur (KL) in 2006. A pilot study was used at our hospital with 199 (KL, 50) premenopausal women with menorrhagia secondary to dysfunctional uterine bleeding. Approval was sought from the Patient Advisory and Liaisons Services (PALS) and data was analyzed using postal questionnaires, Pictorial Blood loss assessment chart diary pre and post treatment, and individual patient case notes. Results: Out of the total of 199 patients who received the treatment, data was analyzed in 171 (KL, 50 and 40 respectively). The mean postoperative period following the study was of 18 months (KL, 6 months). Treatment time averaged 94 seconds (KL, 93 seconds). None of the patients had intraoperative complications (KL, same). 93.6% reported reduction in their periods and 61% reported complete amenorrhoea (KL, 95% and 80% respectively). 58% (KL, 75%) reported improvement in dysmenorrhoea. 85% (KL, 95%) were satisfied with the results. Conclusions: Novasure provides a safe, effective and rapid treatment option for menorrhagia and potentially avoids major surgery. It has a short intraoperative time and can be performed at anytime during menstrual cycle without the need for endometrial pretreatment. Results of our study are comparable to the figures quoted by the manufacturers. These observations are very valuable during preoperative counseling of patients undergoing novasure endometrial ablation. Hysterectomy was avoided in 95.53%.
R. Elsheikh, A. Daak, M. Elsheikh, M. Karsany, I. Adam Background: The epidemiology of viral hepatitis during pregnancy is essential for health planners and programme managers. While much data exist concerning viral hepatatis during pregnancy in many African countries, no proper published data are available in Sudan. Aim: The study aimed to investigate the sero-prevalance and the possible risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) among antenatal care attendants in central Sudan. Methods: During 3 months from March-June 2006, sera were collected from pregnant women at Omdurman Maternaty Hospital in Sudan and they were tested for markers of hepatitis B virus (HBVsAg) and anti-HCV. Results: HBVsAg was detected in 41 (5.6%) out of of 728 women, Anti-HCV was detected in 3 (0.6%) out of 423 women, all of them were not aware of their condition. Age, parity, gestational age, residence, history of blood transfusion, dental manipulations, tattooing and circumcision did not contribute significantly to increased HBVsAg sero-positivity. Conclusion: Thus 5.6% of pregnant women were positive for HBVsAg irrespective of their age, parity and sociodemographic characteristics. There was low prevalance of Anti-HCV. O269 Multiple pregnancies: risks and outcome O. Elsraiti, F. Essadi, M. Elmehashi, E. Bakosh Objective: Data of multiple pregnancies to be analysed in comparison to other studies and to find out whether maternal and perinatal mortality and neonatal morbidity are influenced by mode of delivery. Methods: We reviewed medical records of all women with multiple pregnancies who delivered in Misurata Teaching Hospital during a period of one year (1/6/2007–31/5/2008). Data analysed using chisquare test and P-value considered to be significant if <0.05. Results: Total number of deliveries was (7736). The number of multiple delivers was (130), twins (121), triplet (7) & quadriplet
instrumental delivery & birth trauma were excluded. 100 patients were received either oxytocin or methergine immediately after delivery, & 100 patients were received misoprostol 400 mg either buccal (50 patients) or rectal (50 patients) immediately after delivery, both groups were around the same parity, around 70% of the patient were ≤p4 & 30% were >p4. In group (1) oxytocin group 21 patient develop P.P.H & 4 patient need blood transfusion. In group (2) misoprostol group, 6 patients develop P.P.H after misoprostol And given piton ± methergine in this category the birth weight of the baby >4 kg One of them receive 1 unit blood transfusion & one of them post partum evacuation done because of retained placental tissue. All these patients were >85 kg weight & there age between 25–34 years. In misoprostol group (group 2) 2 patient developed diarrhea & 3patient developed vomiting as drug side effect. There’s no significant difference in the effect &side effect of misoprostol which given either rectally or buccal, but buccal is more accepted by the patient. There’s no significant difference in days of hospital stay between the two groups. Results of our study show that: There’s significant Reduction of p.p.H & the need of blood transfusion when misoprostol used instead of oxytocin or methergine as an active management of 3rd stage of labour. In conclusion, P.p.H witch occur with misoprostol could be related to the patient weight & to the baby birth weight. O266 From Kuala Lumpur (2006) to Cape Town (2009), novasure impedance controlled endometrial ablation – Three-year follow up
S169
O267 Ultrasonographic evaluation of lower uterine segment thickness in pregnant women with previous cesarean section D. Elmoghazy. Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Egypt Objective: To evaluate the lower uterine segment thickness in pregnant women with previous cesarean section by ultrasonography in comparison to those with previous normal vaginal delivery, and to determine a critical thickness above which safe vaginal delivery is predictable. Methods: A prospective observational study of 100 antenatal women with previous cesarean delivery and 50 controls was carried out. Transabdominal and transvaginal ultrasonography were used in both groups to evaluate lower uterine segment thickness. The obstetric outcome in patients with successful vaginal birth and intraoperative findings in women undergoing cesarean delivery were correlated with lower segment thickness. Results: The overall vaginal birth after cesarean section (VBAC) was 68%, the incidence of dehiscence was 28%, and there were no uterine ruptures. There was an 86% correlation between transabdominal ultrasonography with magnification and transvaginal ultrasonography. The critical cutoff value for safe lower segment thickness, derived from the receiver operator characteristic curve, was 2.5 mm. Conclusion: Ultrasonographic evaluation permits better assessment of the risk of scar complication intrapartum, and could allow for safer management of delivery.
A. Elmardi1 , M. Hamza, S. Furara, F. Khan, I. Gallos, A. Yagoub. 1 Obstetrics and Gynaecology department, Stafford General Hospital, Stafford, UK
O268 Hepatitis B virus and Hepatitis C virus in pregnant Sudanese women
Objectives: – To assess the safety, efficacy and patient satisfaction after the procedure in women with menorrhagia secondary to dysfunctional uterine bleeding – To compare our current results (bigger sample size and longer duration post treatment) to initial results presented at Kuala Lumpur in 2006. Materials and Methods: Note: The numbers into brackets represent our initial figures presented at Kuala Lumpur (KL) in 2006. A pilot study was used at our hospital with 199 (KL, 50) premenopausal women with menorrhagia secondary to dysfunctional uterine bleeding. Approval was sought from the Patient Advisory and Liaisons Services (PALS) and data was analyzed using postal questionnaires, Pictorial Blood loss assessment chart diary pre and post treatment, and individual patient case notes. Results: Out of the total of 199 patients who received the treatment, data was analyzed in 171 (KL, 50 and 40 respectively). The mean postoperative period following the study was of 18 months (KL, 6 months). Treatment time averaged 94 seconds (KL, 93 seconds). None of the patients had intraoperative complications (KL, same). 93.6% reported reduction in their periods and 61% reported complete amenorrhoea (KL, 95% and 80% respectively). 58% (KL, 75%) reported improvement in dysmenorrhoea. 85% (KL, 95%) were satisfied with the results. Conclusions: Novasure provides a safe, effective and rapid treatment option for menorrhagia and potentially avoids major surgery. It has a short intraoperative time and can be performed at anytime during menstrual cycle without the need for endometrial pretreatment. Results of our study are comparable to the figures quoted by the manufacturers. These observations are very valuable during preoperative counseling of patients undergoing novasure endometrial ablation. Hysterectomy was avoided in 95.53%.
R. Elsheikh, A. Daak, M. Elsheikh, M. Karsany, I. Adam Background: The epidemiology of viral hepatitis during pregnancy is essential for health planners and programme managers. While much data exist concerning viral hepatatis during pregnancy in many African countries, no proper published data are available in Sudan. Aim: The study aimed to investigate the sero-prevalance and the possible risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) among antenatal care attendants in central Sudan. Methods: During 3 months from March-June 2006, sera were collected from pregnant women at Omdurman Maternaty Hospital in Sudan and they were tested for markers of hepatitis B virus (HBVsAg) and anti-HCV. Results: HBVsAg was detected in 41 (5.6%) out of of 728 women, Anti-HCV was detected in 3 (0.6%) out of 423 women, all of them were not aware of their condition. Age, parity, gestational age, residence, history of blood transfusion, dental manipulations, tattooing and circumcision did not contribute significantly to increased HBVsAg sero-positivity. Conclusion: Thus 5.6% of pregnant women were positive for HBVsAg irrespective of their age, parity and sociodemographic characteristics. There was low prevalance of Anti-HCV. O269 Multiple pregnancies: risks and outcome O. Elsraiti, F. Essadi, M. Elmehashi, E. Bakosh Objective: Data of multiple pregnancies to be analysed in comparison to other studies and to find out whether maternal and perinatal mortality and neonatal morbidity are influenced by mode of delivery. Methods: We reviewed medical records of all women with multiple pregnancies who delivered in Misurata Teaching Hospital during a period of one year (1/6/2007–31/5/2008). Data analysed using chisquare test and P-value considered to be significant if <0.05. Results: Total number of deliveries was (7736). The number of multiple delivers was (130), twins (121), triplet (7) & quadriplet